In 1994 I was diagnosed with celiac disease, which led me to create Celiac.com in 1995. I created this site for a single purpose: To help as many people as possible with celiac disease get diagnosed so they can begin to live happy, healthy gluten-free lives. Celiac.com was the first site on the Internet dedicated solely to celiac disease. In 1998 I founded The Gluten-Free Mall, Your Special Diet Superstore!, and I am the co-author of the book Cereal Killers, and founder and publisher of Journal of Gluten Sensitivity.

By Scott Adams

Published on 09/28/2007

Celiac disease is one of
the most common lifelong disorders in western countries. However, most
cases in North America remain currently undiagnosed, mostly because they
present unusual symptoms and because of the low number of doctors who
have a sound awareness of celiac disease.

Celiac.com 09/28/2007 - Celiac disease is one of
the most common lifelong disorders in western countries. However, most
cases in North America remain currently undiagnosed, mostly because they
present unusual symptoms and because of the low number of doctors who
have a sound awareness of celiac disease.

In a large European survey, the ratio between diagnosed and undiagnosed
cases, found by mass serological screening, was as high as 1 to 7 ,
an effect termed the ‘celiac iceberg’. In addition to having
chronic symptoms that might otherwise respond to a gluten-free diet,
undiagnosed patients are exposed to the risk of long-term complications
of celiac disease, such as anemia, infertility, osteoporosis, or cancer,
particularly an intestinal lymphoma.

Celiac Disease is diagnosed by confirming the presence of intestinal
damage to the small intestine through a biopsy, along with a clinical
response to the gluten-free diet. However, serological markers, e.g., the IgA class
anti-tissue transglutaminase (tTG) antibodies, are useful screening
tests. The sensitivity and the specificity of the IgA anti-tTG test
are 94% and 97%, respectively.

To address the large number of undiagnosed cases, a team of researchers
recently set out to assess whether an active case-finding strategy in
primary care could lead to increased frequency of celiac disease diagnosis, and
to assess the most common clinical manifestations of the condition.

737 women and 239 men, with a median age of 54.3 years, who attended
one of the practices participated in a multi-center, prospective study
involving adult subjects during the years 2002-2004. All individuals
with celiac-associated symptoms or conditions were tested for immunoglobulin
A anti-transglutaminase (tTG) antibodies. Those with elevated anti-tTG
were then tested for IgA antiendomysial antibodies (EMA). All who were
positive for EMA were advised to undergo an intestinal biopsy and HLA
typing.